Medicaid Eligibility ME Codes

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MXIX

Medicaid Eligibility (ME) Code Chart/Hierarchy Level

Hierarchy level	ME Code	Program	Program Description	MEDES Coverage Category	FAMIS Medicaid Category	Processing Timeframe	Prior Quarter	Mandatory/Non-Mandatory	Eligibility and Coverage Start Date
01	07		IV-E Foster Care	N/A	N/A
01	29		DYS Foster Care	N/A	N/A
01	30		JC Foster Care	N/A	N/A
01	31		PSY-State	N/A	N/A
01	32		PSY-Private	N/A	N/A
01	35		IV-E Adoption Subsidy	N/A	N/A
01	36		IV-E Adoption Subsidy FFP	N/A	N/A
01	37		Title XIX FFP	N/A	N/A
01	50		DYS Pov	N/A	N/A
01	56		AFDC Foster Care	N/A	N/A
01	70		JC-Pov	N/A	N/A
02	63		Child Welfare Service – FFP-HIF	N/A	N/A
02	66		Child Welfare Service – FFP-HIF	N/A	N/A
02	68		DYS-HIF	N/A	N/A
02	69		JC-HIF	N/A	N/A
03	08		Child Welfare Service – Foster Care	N/A	N/A
03	52		DYS-GR	N/A	N/A
03	57		Child Welfare Service – Foster Care	N/A	N/A
04	64		Group Home - HIF	N/A	N/A
06	10		Refugee	N/A	N/A
06	19		Refugee	N/A	N/A
06	21		Refugee	N/A	N/A
06	24		Refugee	N/A	N/A
06	26		Refugee	N/A	N/A
06	83		BCCT PE	N/A	N/A
06	84		BCCT	N/A	N/A
07	17		Refugee AFDC	N/A	N/A
07	20		Refugee AFDC	N/A	N/A
07	22		Refugee AFDC	N/A	N/A
07	25		Refugee AFDC	N/A	N/A
07	27		Refugee AFDC	N/A	N/A
09	65		IM-Group Home-HIF	N/A	N/A
10	28		DMH- Foster Care	N/A	N/A
10	49		DMH-Pov	N/A	N/A
10	51		HDN-Pov	N/A	N/A
10	88		Vol Placements	N/A	N/A
11	38		Independent Foster Care	N/A	N/A
11	67		DMH-HIF	N/A	N/A
07	05 06	1	MO HealthNet for Families	MHF Adult 05 MHF Child 06		30 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
13	E2	1	Adult Expansion Group	MHF AEG		30 Days	Yes	N/A	First Day of Month of Application or First Day of Month Eligibility Met. NOTE: Cannot be prior to 07/01/2021
07	05 06	1	Transitional MO HealthNet	TMH Adult 05 TMH Child 06		N/A	N/A	Mandatory	When a MO HealthNet for Families (MHF) family becomes ineligible for MHF
05	18	1	MO HealthNet for Pregnant Women (MHF Std)	MPW MHF 18		15 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
07	40	1	MO HealthNet for Kids Non- CHIP	MHK POV 40		30 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
05	43	1	MO HealthNet for Pregnant Women (Post-Partum coverage under MHF Std)	Post-Partum MHF 43		N/A	N/A	Mandatory	Date Pregnancy Ends
05	44	1	MO HealthNet for Pregnant Women (Post-Partum coverage under Poverty Std)	Post-Partum POV 44		N/A	N/A	Mandatory	Date Pregnancy Ends
05	45	1	MO HealthNet for Pregnant Women	MPW POV 45		15 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
15	58	1	Temporary MO HealthNet During Pregnancy (Subsidized)	N/A		5 Days	No	Presumptive Eligibility	Date Presumptive Eligibility Application Taken by Provider
07	60	1	Newborn	Newborn 60		10 Days	N/A	Mandatory	Child's Date of Birth
05	61	1	MO HealthNet for Pregnant Women	MPW-HIF 61		15 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
08	62	1	Non-Chip MHK Under Age One	MHK Under One 62		30 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
19	81		Reinstatement GR	N/A	N/A
18	90		MHYA BHC Pov	N/A	N/A
16	09		GR	N/A	N/A
14	79		CP Pov	N/A	N/A
14	77		NCP Pov	N/A	N/A
14	76		ETMA Pov	N/A	N/A
13	78		PFS NCP	N/A	N/A
12	9S		SMHB NB CHIP	N/A	N/A
08	6S		SMHB NB MC	N/A	N/A
07	39		Aid for Fam w Dep Child (KIDS)	N/A	N/A
03	5A		Adopt/GR Sub SF	N/A	N/A
03	0F		FC Title IV-E SF	N/A	N/A
07	4M	1	Chip-4M Children's Health Insurance Program Non-Premium Level of Care	CHIP 4M		30 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
12	71 (Age 1-5) 72 (Age 6-18)	1	MO HealthNet for Kids CHIP non-premium	CHIP 71 CHIP 72		30 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
16	59		TEMP for Preg Woman state funds only	N/A	N/A
12	73	1	MO HealthNet for Kids CHIP premium 1%	CHIP 73		30 Days	No	Non-Mandatory	Eligibility Starts: The Date of Application, or First Day of the Month Determined Eligible if After the Month of Application Coverage Starts: The Date of the Application or the Date the Premium has Been Paid, whichever is Later
12	74	1	MO HealthNet for Kids CHIP premium 3%	CHIP 74		30 Days	No	Non-Mandatory	Eligibility Starts: The Date of Application, or First Day of the Month Determined Eligible if After the Month of Application Coverage Starts: The Date of the Application or the Date the Premium has Been Paid, whichever is Later
12	75	1	MO HealthNet for Kids CHIP premium 5%	CHIP 75		30 Days	No	Non-Mandatory	Eligibility Starts: No earlier than 30 days from the date of application. Coverage Starts: The Date the Premium is Paid Please Note: For Children with Special Healthcare Needs, Eligibility Starts: The Date of Application Coverage Starts: The Date of the Application or the Date the Premium has Been Paid, whichever is Later
18	80	1	Extended Women's Health Services	EWHS 80		N/A	N/A	Non-Mandatory	First Day of the Month Following the End of Their Post- Partum Period
06	87	1	Presumptive Eligibility Children	N/A		5 Days	No	Presumptive Eligibility	Date Presumptive Eligibility Application Taken by Provider
07	05	1	Presumptive Eligibility Parent & Caretaker Relative	N/A		5 Days	No	Presumptive Eligibility	Date Presumptive Eligibility Application Taken by Provider
18	89	1	Uninsured Women's Health Services	UWHS 89		30 Days	No	Non-Mandatory	First Day of Month of Application
15	94	1	Show-Me Healthy Babies Presumptive Eligibility	N/A		5 Days	No	Presumptive Eligibility	Date Presumptive Eligibility Application Taken by Provider
05	95	1	Show-Me Healthy Babies Pregnant Women	SMHB 95		15 Days	No	Non-Mandatory	Date of Application
05	96	1	Show-Me Healthy Babies Unborn Child	SMHB 96		15 Days	No	Non-Mandatory	Date of Application
12	97	1	Show-Me Healthy Babies Newborns age 0 to 1	SMHB 97		10 Days	No	Non-Mandatory	Child's Date of Birth
05	98	1	Show-Me Healthy Babies Post-Partum	SMHB 97		N/A	No	Non-Mandatory	Date Pregnancy Ends
10	01	2	Conversion Case - Old Age Assistance SSI-SP, SSI, SP		N/A	New eligibility is not determined	No	Mandatory	N/A
16	02	2	Blind Pension (BP)		BPCSH - BP Cash BPNPT - No Payment	90 Days	No	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met. *SAB cash grant is mandatory but the Medicaid is optional, therefore, AEG could be the Medicaid option for the participant
10	03	2	Aid to the Blind - Supplemental Aid to the Blind (SAB)		SABCSH - SAB Cash SABNPT - SAB No Payment	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met. *SAB cash grant is mandatory but the Medicaid is optional, therefore, AEG could be the Medicaid option for the participant
10	04	2	Conversion Case - Permanently and Totally Disabled SSI-SP. SSI, SP		N/A	New eligibility is not determined	No	Mandatory	N/A
10	11	2	MO HealthNet - Old Age Assistance Vendor		Vendor	45 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	11	2	MO HealthNet - Old Age Assistance Non-Spend Down (NSD)		MHNS	45 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	11	2	MO HealthNet - Old Age Assistance HCB		HCB	45 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month (FSD and DHSS) Eligibility Met
10	11	2	MO HealthNet â HCB applicant age 63 or 64		HCB	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	11	2	MO HealthNet - Old Age Assistance Spend Down (SD)		MHSD	45 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	12	2	MO HealthNet Aid to the Blind Vendor		BPVND - BP Vendor BPVNH - BP Vendor DMH Placement	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	12	2	MO HealthNet Aid to the Blind Non-Spend Down (NSD)		MHNS	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	12	2	MO HealthNet Aid to the Blind HCB		HCB	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month (FSD and DHSS) Eligibility Met
10	12	2	MO HealthNet Aid to the Blind Spend Down (SD)		MHSD	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
07	47		MPW-60-Ref-Pov	N/A	N/A
07	42			MHK Pov Vendor	N/A
07	46		MPW-Ref-Pov	N/A	N/A
07	48		Refugee Pov Child	N/A	N/A
07	53		DYS-GR	N/A	N/A
07	54		DYS-GR	N/A	N/A
10	13	2	MO HealthNet - Permanently and Totally Disabled Vendor		VENDOR	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	13	2	MO HealthNet - Permanently and Totally Disabled Non-Spend Down (NSD)		MHSD	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	13	2	MO HealthNet - Permanently and Totally Disabled HCB		HCB	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month (FSD and DHSS) Eligibility Met
10	13	2	MO HealthNet - Permanently and Totally Disabled Spend Down (SD		MHSD	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	14	2	Supplemental Nursing Care - Old Age Assistance		NCSNFD NCSNF NCALFD NCALF NCRCFD NCRCF	45 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	15	2	Supplemental Nursing Care - Aid to the Blind		NCSNFD NCSNF NCALFD NCALF NCRCFD NCRCF	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	16	2	Supplemental Nursing Care - Permanently and Totally Disabled		NCSNFD NCSNF NCALFD NCALF NCRCFD NCRCF	90 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	23	2	MO HealthNet for Kids in Vendor Institution		JCOMHF	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	33	2	MO Children with Developmental Disabilities (DMH Match)		MOCK	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	34	2	MO Children with Developmental Disabilities (DSS Match)		MOCB	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	41	2	MO HealthNet for Kids in Vendor Institution - Poverty		JCOPOV	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
17	55	2	Qualified Medicare Beneficiary (QMB)		QMB - less than or equal to 100% FPL	45 Days	No	Mandatory	Eligibility begins month *after* application approval
19	82	2	Specified Low Income Medicare Beneficiary (SLMB)		SLMB1 - less than or equal to 120% FPL SLMB2 - less than or equal to 135% FPL	45 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
	00	2	Qualified Working Disabled Individual (QWDI)		QDWI	45 Days	No	Non-Mandatory	First Day of the Month of Application
19	82	2	MO RX (Medicare Part D wrap-around benefits) - SLMB		SLMB	45 Days	Yes	Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	85	2	Ticket to Work Health Assurance (TTW) - Premium		TWT1	90 Days	Yes	Non-Mandatory	First Day of Month of Application or First Day of Month Eligibility Met
10	86	2	Ticket to Work Health Assurance (TTW) - Non Premium		TWT2	90 Days	Yes		First Day of Month of Application or First Day of Month Eligibility Met
20	91		Gateway Tier 1/2 Joint coverage enrollees		TIER1	30 Days	No		First Day of Month of Application
20	92	2	Gateway Tier 1/2 Joint coverage enrollees 0-133% FPL		TIER2	30 Days	No		First Day of Month of Application
20	93		Gateway Tier 1/2 Joint coverage enrollees 134-200% FPL		TIER2	30 Days	No		First Day of Month of Application